**3. Biofilm formation and regulation**

Wound contamination happens within minutes when planktonic (free-swimming) microorganisms travel into the wound, anchor to the wound bed, and become attached (sessile) [57]. Bacteria produce sticky sugar strands or polymers known as extracellular polymeric substances (EPS) when attached to the wound bed. These polymers form bonds with the help of metallic ions obtained from the host and wound environment, forming a three-dimensional protective structure that grows

into a complex community developed to protect the encased bacteria compared to assault through the body's immune system or external attack.

## **3.1 Steps of biofilm formation**

The development of a biofilm actually involves a combination of physical, chemical, and biological processes that proceed over a period of time. Detailed procedures of bacterial biofilm formation are illustrated in **Figure 1**.
